Tiêu đề Respiratory Infections, Pleural Condition and Pulmonary Embolism.pdf ✅

RESPIRATORY INFECTIONS AND PLEURAL CONDITION ABU-IRTAIMEH & JAWARNEH 0 COPD Bronchiectasis and Asthma
RESPIRATORY INFECTIONS AND PLEURAL CONDITION ABU-IRTAIMEH & JAWARNEH 1 Respiratory Infections Acute Tracheabronchitis - Acute inflammation of the mucous membrane of the trachea and bronchial tree. - Causes: Infection (URTI), inhalation of physical and chemical irritant, gases. - Pathophysiology: inflamed mucosa from (SP (streptococccus pneumonia), HI, MP (mycoplasma pnem)) or fungal agent produce mucopurelant sputum - C\M initially the pt c\o:  dry irritating cough  scanty amount of mucoid sputum  retrosternal soreness may occur  fever and chills, headache, general malaise - C\M: as infection progress: S.O.B, noisy inspiration and expiration, purulent (puss filled) sputum occur. - Dx evaluation: sputum culture and sensitivity C&S - Medical Management:  AB (antibiotics)  expectorant  increase fluid intake  steam inhalation  moist heat to the chest  analgesic & antipyretic - Nursing Management:  Increase fluid intake  coughing exercise
RESPIRATORY INFECTIONS AND PLEURAL CONDITION ABU-IRTAIMEH & JAWARNEH 2  place pt in setting position  instruct pt to complete the course of AB treatment  avoid overexertion & instruct pt to rest Pneumonia (Chest Infection): - Is an inflammation of the lung parenchyma, caused by various microorganisms - Classification (common classifications): Community Acquired Pneumonia (CAP), Hospital Acquired Pneumonia (HAP), pneumonia in immunocompromised host, Aspiration Pneumonia. Others: Bacterial or typical, atypical, anaerobic, opportunistic, CAP:  Occurs in the community setting or within the first 48hr’s after hospitalization  The causative agents: S.pneumoniae, H.influanzae, legionella, pseudomonas areuginosa  The most common CAP the S.pneumoniae (pnemococcus), occur in people younger than 60y without comorbidity and ≥ 60y with comorbidity - Mycoplasma pneumonia another type of CAP, caused by Mycoplasma pneumonia, occur in olds, children, and young adults - H. influanzae another cause of CAP, affects elderly with comorbid illness (DM) HAP:  Known as nosocomial pneumonia  Onset of pneumonia symptoms >48hr’s after admission in pt with no evidence of infection at the time of admission  Organism responsible as: Enterobacter species (EC), Klebseilla species, Staphylococcus. Aureus, S. pneumonia. Pneumonia in the immunocompromised host:  Include Pneumocystis Carinii Pneumonia (PCP), fungal pneumonia, mycobacterium tuberculosis.  The organism that causes CPC now known as Pneumocystis jiroveci Pneumonia  Occur with use of corticosteroid, chemotherapy, AIDs, and other factor that cause CAP and HAP
RESPIRATORY INFECTIONS AND PLEURAL CONDITION ABU-IRTAIMEH & JAWARNEH 3 Aspiration Pneumonia:  Refer to the pulmonary consequences resulting from entry of endogenous or exogenous (Triggers inflammatory changes and inactivate surfactants leads to alveolar collapse) substances into the lower airway.... (most commonly: bacteria reside normally in URT)  Common pathogens: S. pneumonia, H. influenza, S. aureus  Other causes aspiration of gastric content, irritating gases. Pathophysiology  Affect both ventilation and diffusion  Inflammatory reaction occurs in the alveoli produce exudates which interfere with diffusion of O2 and CO2  Area of lungs not adequately ventilated  If one or more lobes is involved this called “lobar pneumonia”, the entire lobe of lung consolidated.  If one or more localized area within the bronchi and extending to the surrounding parenchyma this called “bronchopneumonia”, patchy area of consolidation occurs  Bronchopneumonia more common than lobar pneumonia lobar pneumonia bronchopneumonia Risk Factors  Cancer, smoking, COPD (produce mucus, or obstruct bronchus  Immunocompromised pt  Prolonged immobility and shallow breathing  Depressed cough reflex, aspiration of foreign material  Alcoholism  General Anastasia, sedative  Advance age  Respiratory therapy with improperly cleaned equipment  Transmission of organisms from staff of health care. Clinical Manifestation  Sudden onset of chills, rapid raising fever (38.5o – 40.5o )